FORM D - comply4HR



Payment of Bonus Act

FORM D

See rule 5

ANNUAL RETURN-BONUS PAID TO EMPLOYEES FOR THE ACCOUNTING YEAR

ENDING ON THE

1. Name of the establishment and its complete postal address:

2. Nature of industry:

3. Name of the employer:

4. Total number of employees:

5. Number of employees benefited by bonus payments:

|Total amount payable as bonus under |Settlement, if any reached under section 18(1)|Percentage of bonus |Total amount of bonus |Date on which |Whether bonus has been |Remark |

|section 10 or 11 of the Payment of Bonus |or 12(3) of the Industrial Disputes Act. 1947 |declared to be paid |actually paid |payment made |paid to all the | |

|Act, 1965 as the case may be |with date | | | |employees, if not, | |

| | | | | |reasons for non-payment | |

|(1) |(2) |(3) |(4) |(5) |(6) |(7) |

| | | | | | | |

| | | | | | | |

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Signature of the employer or his agent

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